Able-bodied individuals with normal pressure sensation avoid acquiring pressure sores by subconsciously moving and shifting their weight so that no single area is over-exposed to constant pressure. However, pressure ulcers are a common complication among elderly, diabetic and spinal cord injured (“SCI”) populations. Impaired sensation in affected areas can lead to a patient failing to recognize warning signs such as pain and discomfort on areas of the skin that have pressure applied. These areas often include, but are not limited to, bony prominences such as the heel, the coccyx, and ischial tuberosities (the “sit bones”). While pressure sores are usually preventable, these injuries can disrupt rehabilitation or interfere with work, school or community reintegration. Severe pressure sores can lead to a decrease in a person's mobility and independence and can lead to further disability, fatal infections and may ultimately require surgical intervention. Depending on the severity of the injury, a patient's treatment of pressure ulcers can take weeks or even months. Nationwide treatment has been estimated to cost more than $1.2 billion annually.
The prevention of pressure ulcers begins immediately after injury and is a lifelong commitment for those with SCI (or other conditions) and their caregivers. Prevention requires education and vigilance and may involve: regular examinations of skin on areas that receive pressure; limiting moisture and keeping skin as dry as possible; building an individually-prescribed, custom wheelchair cushion and seating system; making necessary changes to diet such as limiting alcohol intake and eating a balanced diet; and, monitoring a person's weight changes.
Current standards of care for SCI individuals suggest a pressure relief procedure be performed by leaning forward, leaning from side-to-side, or lifting up every 15 to 30 minutes for 30 to 120 seconds in order to minimize or prevent the development of pressure ulcers. The particular techniques for performing a pressure relief procedure (sometimes referred to as a pressure release or simply a release) are dependent on the abilities of the individual. For example, individuals who are unable to relieve pressure manually can release pressure by reclining in a powered chair.